Treatment of cancer of the floor of mouth and tongue

Abstract

0 N reviewing medica Iiterature describing treatment of cancer of the floor of the mouth and tongue we find many differences as to the recommended therapy. There are numerous varied methods of treatment, each with its proponents. The Tumor Clinic is staffed by pathoIogists, radioIogists, oncologists and surgeons, and these together decide the appropriate correIation of surgery and/or radiation therapy. We have anaIyzed our results with the aim of determining the best pattern of therapy according to the Iocation and extent of each Iesion. Over a third of the patients with cancer of the floor of the mouth and the tongue treated at the Veterans Administration HospitaI, Atlanta, Georgia, from 1936 to 1940 are now without evidence of disease. FoIIow-ups have been IOO per cent. Many patients who have not been cured have received appreciabIe paIIiation, which has resuIted in their added comfort and extension of Iife for severa years. For purposes of anaIysis the cases presented wiI1 be divided into anatomic sites invoIved by the tumor: (I) ffoor of the mouth, (2) anterior two-thirds of the tongue and (3) base (posterior third) of the tongue. Such a division is indicated by the pathoIogic condition encountered and by the mode of treatment which can be used. Lesions of the floor of the mouth appear to have the lowest grade of maIignancy. The first metastases from this area are usuaIIy found submentaIIy, and extension into the mandible is frequent. When the primary tumor is in the anterior two-thirds of the tongue, the grade of maIignancy is, as a ruIe, higher. Such tumors metastasize frequentIy to the carotid areas, as we11 as the submaxiIIary areas. If the carcinoma originates in the base of the tongue, it wiI1 in a11 probabiIity be stiI1 more active. Extensive neck metastases frequentIy occur from cancers in the base of the tongue because Cuba Lexington, Kentucky